Engagement in physical education classes and health among young people: does sports practice matter? A cross-sectional study

ABSTRACT CONTEXT AND OBJECTIVE: Physical education classes aim to promote health but it is unknown whether benefits occur independently of sports practice. The purpose of this study was to examine associations between engagement in physical education classes and physical fitness and obesity according to sports practice among Brazilian students. DESIGN AND SETTING: Cross-sectional school-based study involving 737 students aged 10-17 years in southern Brazil. METHODS: Engagement in physical education classes and sports practice were analyzed using a self-report questionnaire. The health indicators analyzed were cardiorespiratory fitness, muscle strength, obesity and combinations thereof. The covariates were sex, age, socioeconomic status, physical activity and sedentary behavior. Prevalence ratios (PR) adjusted for confounding variables were estimated using Poisson regression. Analyses were stratified according to sports practice. RESULTS: Engagement in physical education classes was associated with achievement of health-related criteria for cardiorespiratory fitness (PR = 1.52), muscle strength (PR = 1.55), obesity + cardiorespiratory fitness (PR = 1.51), obesity + muscle strength (PR = 1.70), cardiorespiratory fitness + muscle strength (PR = 2.60) and the three outcomes combined (PR = 2.43), only among non-sports practitioners, all P 0.05). No associations were found for sports practitioners (P > 0.05). CONCLUSION: Engagement in physical education classes was associated with health among non-sports practitioners. However, to protect students from obesity and promote additional health benefits for sports practitioners, the conventional physical education program offered to the sample studied should be reformulated.【研究背景与目的】：体育课程旨在促进学生健康，但目前尚不明确其健康益处是否独立于日常体育运动实践而产生。本研究旨在探究巴西学生参与体育课程的情况与体能、肥胖之间的关联，并按是否参与体育运动进行分层分析。 【研究设计与实施场景】：本研究为基于学校的横断面研究，共纳入巴西南部地区737名10~17岁的学生。 【研究方法】：采用自报告问卷对学生参与体育课程及体育运动实践的情况进行评估。本次分析的健康指标包括心肺耐力（cardiorespiratory fitness）、肌肉力量（muscle strength）、肥胖及其联合指标。协变量涵盖性别、年龄、社会经济地位、身体活动量及久坐行为。采用泊松回归（Poisson regression）估算校正混杂变量后的患病率比（PR），并按是否参与体育运动对分析进行分层。 【研究结果】：仅在非体育运动参与者中，参与体育课程与达到健康相关标准的心肺耐力（PR=1.52）、肌肉力量（PR=1.55）、肥胖+心肺耐力（PR=1.51）、肥胖+肌肉力量（PR=1.70）、心肺耐力+肌肉力量（PR=2.60）以及三项指标联合达标（PR=2.43）均存在显著关联，所有P值均<0.05。而在体育运动参与者中未发现此类关联（P>0.05）。 【研究结论】：仅在非体育运动参与者中，参与体育课程与健康状况存在显著关联。然而，为保护研究样本中的学生免受肥胖困扰，并为体育运动参与者带来额外健康益处，现有针对该研究群体的常规体育课程方案亟需进行优化调整。